You’re tired all the time. Your skin might look pale. You might be short of breath. Does that sound like you? If that’s your case, you just might have iron deficiency/low ferritin (ferritin is the storage form of iron, so the two terms will be used interchangeably). Congratulations. Admitting you have a problem is the first step.
And if you do have iron deficiency anemia (the medical term for “iron deficiency”), how should you exercise? How should you modify your fitness routine? That’s what we’ll talk about in this article. Additionally, we’ll cover:
- Symptoms of anemia
- The 4 reasons your iron status might be low
- Does exercise deplete iron?
- Iron deficiency anemia and exercise precautions
- Can exercise help with anemia?
- How you should exercise if you have low iron status.
- Most common treatments for iron deficiency
Original source: here.
But first, gather round, put your thinking cap on, and let me explain what iron does in your body.
According to WebMD, Iron is a mineral that is part of a protein called “hemoglobin” (or if you’d like to use the British spelling, you can spell it “haemoglobin.” Don’t you feel more sophisticated and intelligent spelling it that way?). Hemoglobin is a component of your red blood cells that gives you energy and endurance, because it carries oxygen in the blood.
If you are low in iron, there is less oxygen in your body. It also make it hard to lose weight.
If you want to watch the video associated with this article, here it is:
Symptoms of Anemia
Here are the most common symptoms for iron deficiency anemia:
- Pale skin
- Low energy levels
- Headache, especially with or after physical activity
- Overall body weakness
- Low endurance
…and others.
The 4 Reasons Your Iron Status Might be Low
Why might you be low in iron? There are 4 reasons:
- Insufficient dietary iron intake. Eating an iron deficient diet is a potential cause of iron deficiency. This may be the case if you are a vegetarian or vegan, because typically the best sources of iron are red meat.
- Your body might be getting enough iron in the diet, but it’s not getting absorbed by your body. So you have poor iron absorption.
- Excessive losses. You might be a female who has a high blood loss during your periods (along with high blood loss comes high iron loss), or you might be an endurance athlete (especially a runner). Ironically (pun intended), each time your foot strikes the ground, you destroy some red blood cells. That’s called “exercise induced anemia.”
- Blocked absorption. You may be taking other supplements or eating other foods that can block the absorption of iron (for example, tea/coffee can block iron absorption. So can raw spinach, but not cooked spinach. And others).
So your first step is to solve your anemia. Don’t just self-diagnose, but go to your doctor to get a blood test that will confirm whether you have anemia or not. If you do, take some specific measures to resolve it. By the way, side note: the word “anemia” doesn’t mean “iron deficiency”. According to the Mayo Clinic, it means low red blood cell count, or low hemoglobin. Low ferritin levels are one cause of it, but it’s not the only cause.
Does Exercise Deplete Iron?
According to one study (and others), yes, working depletes iron. This happens for 3 reasons:
- Mechanical destruction of red blood cells. When you are running, each step you take “squishes” some red blood cells, because you are mechanically crushing the cells that are in the soles of your feet at the time the foot strikes the ground.
- During workouts, more blood goes to the muscles. That means less blood goes to both the digestive and urinary systems. Because of that, blood can be lost due to decreased blood to those areas.
- Iron can be lost in sweat, although the amount is questionable.
Original source: here.
During the time that you are bringing up your iron stores (usually via iron supplementation or eating iron rich foods), it’s certainly a good idea to avoid running, since running works against your efforts to increase your iron.
By the way, iron glycinate (AKA iron bisglycinate) brings up iron levels better than the more common ferrous fumarate or ferrous sulfate, and isn’t constipating, either. You can .
When researchers study whether physical activity depletes iron, they are specifically looking at cardio, and it’s questionable whether the same would apply to strength training.
Also, keep in mind that whether or not working out depletes iron depends on the amount of training. In most research that shows that it does, the researchers are studying female athletes. This may not be the case for both recreational exercisers, and males. Female athletes are usually exercising for over 5 hours per week. I would venture to say that if you’re a recreational exerciser, doing it 3-5 times per week, you don’t have much to worry about.
Iron Deficiency Anemia and Exercise Precautions
There aren’t any specific exercise precautions when it comes to anemia, other than the standard “listen to your body” and “take it easy.”
Basically, expect shortness of breath, but that will force you to take it easy anyway.
If you work out recreationally, consider doing interval training, since it allows you to catch your breath easier.
Original source: here.
Can Exercise Help with Anemia? How to Exercise if You Have Low Ferritin.
In my opinion, yes, exercise can help with anemia, if you do it right. During this time that you have anemia, resistance training, using high repetitions (over 15) with large muscle groups is a great idea. Why? Because endurance comes from two sources:
- How much blood the heart pumps out.
- How much oxygen your muscles extract from the blood.
Doing resistance training with high repetitions enhances your muscles’ ability to extract more oxygen from the blood, so even with iron deficiency anemia, your energy will improve. I write more about strength training here. I also write more about the biochemical differences between men and women.
Original source: here.
Cardio is a two-edged sword: on the one hand, heavy cardio, especially running can deplete your iron even further. However, cardio can also stimulate the production of red blood cells (called “hematopoiesis”). So I would do cardio at low intensities (under 65% of your maximal heart rate, which is 220 minus your age).
Just remember your first order of business: get your iron levels up.
Most Common Treatments for Iron Deficiency
Although this article is not specifically about how to get your iron levels up, I feel like I’d be doing you a disservice if I didn’t address the most common ways to deal with iron deficiency.
Iron Supplements
By far, the most common way of dealing with iron deficiency is to take iron supplements. The most common supplement is ferrous sulfate. Unfortunately it doesn’t work for a large number of people who take it, and some people find that it constipates them. A better form might be (it also comes in “iron bisglycinate“).
Having said that, combining iron with vitamin C helps iron absorption.
Increase Dietary Iron Intake
This one seems obvious, but if your diet is iron deficient (which sometimes happens in a vegetarian diet if you don’t plan it properly) simply eating more iron rich foods that would boost your iron status. And if you want to use the iron-boosting power of vitamin C, eat your steak with some salad. Or have fruits for dessert.
Avoid High Intensity Cardio
Because iron deficiency anemia is more common in athletes doing intense exercise, it is recommended that as long as iron stores are low, intense cardio should be minimal… unless you’re willing to compensate for it with either iron supplements, or foods high in iron.
Why are athletes at higher risk? One reason is that iron is lost in sweat. You sweat more, you lose more iron. Another reason, as mentioned earlier is mechanical destruction of red blood cells. Every time you take a step, you crush some red blood cells, which contain iron.
If you’re wondering how high is high intensity? Generally speaking, if your exercise causes you to feel the lactic acid (that burning in your muscles), you can bet that’s intense. You get that at a heart rate that’s approximately 85% of your maximum.
Improving Digestion/Absorption
Although this is definitely not a common treatment, it’s a very necessary treatment. I can’t tell you how many people tell me that they’re already taking iron supplements, and yet, they still have a low red blood cell count.
So maybe the issue is not intake. Maybe the issue is absorption. Why might you have poor absorption? There are many reasons, like perhaps there are bacteria living in your digestive system that shouldn’t be there, perhaps you have low stomach acid, low enzymes, or low mineral status (you need optimal amounts of other minerals to absorb iron).
Although it’s beyond the scope of this article how to identify if you have poor absorption, and then correct it, I hope that at least, you’ll make sure to consider it as an option. Just bring ask your doctor for the appropriate tests.
